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General NPI Number Information
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NPI Number | 1770120719
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Entity Type | Organization
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Legal Business Name | AMAZING & CREATIVE THERAPY ON THE SPECTRUM LLC
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Dates
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Enumeration Date | 12/10/2019
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 14058 MEMORIAL DR
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City | HOUSTON
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State | TX
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Zip | 77079-6848
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Country | US
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Telephone | 281-752-0403
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Fax | 281-752-0502
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Provider Business Mailing Address
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Address Line | 1307 SHERWOOD POINT LN
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City | HOUSTON
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State | TX
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Zip | 77043-2857
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Country | US
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Telephone | 832-758-0090
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. HYESHIN H BOUWHUIS
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Credential |
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Telephone | 832-758-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225A00000X
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Taxonomy Name | Music Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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